Preventive care=preventing people from seeing their doctor. The old line was the bureaucrats were going to lower the cost of health care by increasing preventive care, and the propaganda was couched to criticize the old system because there was no guided emphasis in prevention. Now we are learning, like every other liberal trope after it has been exposed to sunlight for a while, that this was just another lie to get us to accept rule by bureaucrats.

At my last appointment, my doctor and I actually talked about how crazy it was she was expected to give even elderly women who had never been sexually active pelvic exams for cancers they had almost no risk for.

I love Glen but he has it exactly backwards. Obamacare would strongly prefer that Women's Wellness, in all it unscientific glory, remained intact (aided by free contraception just for women) to show their right thinking ways. Big Healthcare loves Big Government and vice versa. If you imagine a world where female and asymptomatic is NOT a disease state and females pay for their own birth control (as do males or face the consequences), it's tough to see how Liberals can gin up the "War on Women" love machine.

The fact is Women's Wellness is the perfect stew of unscientific nonsense comprised of men's interest in healthy female body parts, untapped and unending billings pool, women's insecurity over their bodies and lack of scientific knowledge, deprivation of informed consent and lack of disclosure and misguided militantism of feminist who saw this wolf in sheep's clothing as an advocate not to be missed.

If you think honestly that shoving gloved fingers up anything provides meaningful healthcare information, I encourage you to do it to yourself and announce to the world that you have magic dysplasia sniffing fingers. Have at it and do report back.

Next up to fail.. Clinical Breast Exams...same obvious reasons. Palpation isn't a valid or I should say useful screen for anything. All stop. Digest. It's laying of hands nonsense that was exploited by an entirely unsupervised, all-male profession with a very novel idea. Note to self: Don't ask a surgeon if you have an anomaly requiring intervention.

Cervical dysplasia is a unique case. Much like sDNA of the colon much better ways to collect specimens outside of clinicians (e.g. livage). HPV infections do NOT just affect the cervix so accuracy improved by not concentrating on that tissue. Almost all cervical dysplasia is entirely innocent anyway. My prediction is that women get cervical dysplasia testing during their colonoscopies (similarly slow pathways and responses) or send in the home test kit looking for HR-HPV strains, particularly 16 and 18). I always thought it was funny that emerging markets were "cursed" with all this screening innovation which allowed them to screen themselves discreetly while American women were so "lucky" to be opened up and scraped by such caring clinicians who would use the opportunity to administer unscientific but similarly invasive nonsense involving all their sex organs (way too often as statistics pointed out).

I'll close by noting the obvious... the national cervical screening program administered in the US CANNOT pass cost-benefit. Yep...cannot. If you look at the pool of cervical cancer diagnoses (CIN3+), it's clear that non-testers (over 5 years since screened) are overrepresented but the proportion of women who are current is disturbing. We are dealing, as with other interesting viral infections like HBV, with early infection on immature tissue and/or immune conditions interfering with clearance. I will close ( a second time) by noting that all the data on reactivation suggests that grandma is having sex with new partners and that reactivation is uncommon in the non-HIV population. Grandma didn't want you to know.

Having listened to my wife (internist) talk about the value of poking and prodding for something like a decade and a half now, color me skeptical that it's all just a male plot. Perhaps her diagnostic skills are false consciousness?

In the age of obozocare it is money over lives, nearly impossible to believe the medical profession any more. It is extremely unnecessary as long as they have to pay for it whether ore not you live is of no consequence.

Actually, you'd be surprised how much healthcare you received over your life...long before Obamacare was a dream in a twisted liberal head...that had absolutely no scientific support and generally failed the sniff test. Do you really think stethoscopes are helpful medical devices or that hitting your knee or probing your abdomen is useful? It isn't. We blow literally over 100 billion annually in this country on magical healthcare pixie dust. The lasses unfortunately suffer more than most because we find their parts particularly interesting...sad but true.

Having these low tech skills actually reduces the need for expensive high tech testing and is how most of the world without the fancy tech massively deployed actually get diagnoses done, including the parts of the world where they have better outcomes and lower costs.

Doctors have, due to financial pressure mostly caused by government pricing schedules that dominate american medicine, taken to writing up quick referrals for the high tech tests because they get patients moving in and out of their offices faster. Your recommendations would increase the trend.

You apparently didn't read the article nor have you read the policy recommendations of advocates for pelvic exams like ACOG. ACOG recommends annual pelvic exams (some would not self-interestedly after the annual pap got pulled from them) based on...wait for it...wait for it.. "expert opinion". Yes, you read that right. My mechanic recommends oil changes every 100 miles on the same basis.

No evidence of benefit.Lots of evidence of harm. Picture cutting and ultrasound transducers going where you wouldn't with them to go.Not a screen for gynecological cancers.The big bogeyman, Ovarian Cancer, is thankfully rare and has a mean age at diagnosis of 66 (yep, it's a stone cold killer....that's true but the best screen right now is CA-125 with ultrasound and that doesn't work well either).

This procedure was never about healthcare as that term was understood. Read up.

In the run up to the passing of the UnAffordable Care act these type of procedures(regardless of the dubious cost benefit ratio of this type of test) were cited ad nauseum as the unassailable reason why Obamacare had to be passed or it was a War on Women.

Rationing health care and denying expensive treatments is evil if done by a private corporation, but fine if done by the government. Nevermind that both are done for the same reason: to keep costs down.

The Left will let government get away with that which it would never tolerate from a private corporation.

So this ties in with the earlier posting of birth control being available OTC. The main reason women get these is for birth control. These exams are given too often especially if the woman is in a low risk group like, virgin, married, long term relationship, and/or celibate.

On the other hand I know women who've had the irregular pap and had to get treated. Cervical cancer deaths in the US are low and abortions are high. Birth control OTC and reducing this exam will flip those statistics.

This is just ignorant. A pelvic exam does NOT inform the decision to prescribe birth control. Birth control was a useful way to enforce compliance. While every major healthcare body (including, belatedly, ACOG) have endorsed OTC treatment, it won't happen because it will crumple the stick part of "carrot and stick".

You are also confusing a pelvic exam with cervical cancer dysplasia which use to be the error prone pap smear but should be co-testing with HPV DNA these days (many providers slow since this means you do this about as often as a colonoscopy).

As far as the notion that we are destined for a bloom in cervical cancer deaths...good luck with that. Long before, pap smears became "routine" (compliance remains relatively low), cervical cancer incidence declined in this country. We know that increased exercise, aspirin consumption, Vitamin D serum levels and reduced smoking rates definitely impact the incidence rate.

The truth is that pap smears as originally rolled out had such god-awful error rates, both positive and negative, that tested women were showing up at good rates in cervical cancer pools while the majority of women without dangerous dysplasia were being roped in as false positives (lifetime false positive risk approximately 60%).

The odd thing about this war on dysplasia is that the pathway to cancer is slow and that every other country on the planet decided 3-5 year testing interval was best to avoid the false positive rate. We however had some folks who weren't interested in the cost of false positives....

Be interesting to see how this affects those malpractice lawsuits which claim that a doctor was negligent because he "should" have run a bunch of unrelated medical tests, even though the patient just came in for something like an infected hangnail.

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